{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T14:02:51Z","timestamp":1772114571613,"version":"3.50.1"},"reference-count":50,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T00:00:00Z","timestamp":1684454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>The incidence of Clostridioides difficile infection (CDI) has been increasing compared to pre-COVID-19 pandemic levels. The COVID-19 infection and CDI relationship can be affected by gut dysbiosis and poor antibiotic stewardship. As the COVID-19 pandemic transitions into an endemic stage, it has become increasingly important to further characterize how concurrent infection with both conditions can impact patient outcomes. We performed a retrospective cohort study utilizing the 2020 NIS Healthcare Cost Utilization Project (HCUP) database with a total of 1,659,040 patients, with 10,710 (0.6%) of those patients with concurrent CDI. We found that patients with concurrent COVID-19 and CDI had worse outcomes compared to patients without CDI including higher in-hospital mortality (23% vs. 13.4%, aOR: 1.3, 95% CI: 1.12\u20131.5, p = 0.01), rates of in-hospital complications such as ileus (2.7% vs. 0.8%, p &lt; 0.001), septic shock (21.0% vs. 7.2%, aOR: 2.3, 95% CI: 2.1\u20132.6, p &lt; 0.001), length of stay (15.1 days vs. 8 days, p &lt; 0.001) and overall cost of hospitalization (USD 196,012 vs. USD 91,162, p &lt; 0.001). Patients with concurrent COVID-19 and CDI had increased morbidity and mortality, and added significant preventable burden on the healthcare system. Optimizing hand hygiene and antibiotic stewardship during in-hospital admissions can help to reduce worse outcomes in this population, and more efforts should be directly made to reduce CDI in hospitalized patients with COVID-19 infection.<\/jats:p>","DOI":"10.3390\/idr15030028","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T01:26:41Z","timestamp":1684459601000},"page":"279-291","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["COVID-19 and Clostridioides difficile Coinfection Outcomes among Hospitalized Patients in the United States: An Insight from National Inpatient Database"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5677-6420","authenticated-orcid":false,"given":"Rehmat Ullah","family":"Awan","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Ochsner Rush Medical Center, Meridian, MS 39301, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karthik","family":"Gangu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8685-0599","authenticated-orcid":false,"given":"Prabal","family":"Chourasia","sequence":"additional","affiliation":[{"name":"Department of Hospital Medicine, Mary Washington Hospital, Fredericksburg, VA 22401, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3569-9360","authenticated-orcid":false,"given":"Oscar F.","family":"Borja Montes","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Ali","family":"Butt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA 15212, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taimur Sohail","family":"Muzammil","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA 15212, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rao Mujtaba","family":"Afzal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Pittsburg Medical Center, Pittsburgh, PA 15213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ambreen","family":"Nabeel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Ochsner Rush Medical Center, Meridian, MS 39301, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1200-6886","authenticated-orcid":false,"given":"Rahul","family":"Shekhar","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0503-6961","authenticated-orcid":false,"given":"Abu Baker","family":"Sheikh","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1016\/j.ajic.2020.09.010","article-title":"Impact of COVID-19 prevention measures on risk of health care-associated Clostridium difficile infection","volume":"49","author":"Bentivegna","year":"2021","journal-title":"Am. 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